2002-2017年上海市金山区慢性非传染性疾病死亡水平及其所致过早死亡风险分析

Analysis on death rate and risk of premature mortality for chronic non-communicable diseases in Jinshan district of Shanghai from 2002 to 2017

目的分析2002-2017年上海市金山区心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病4类慢性病早死概率及变化趋势,为建立和制定慢性病早死概率控制目标及慢性病防治措施提供依据。方法建立2002-2017年金山区居民慢性病死亡数据库,计算心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病4类主要慢性病的粗死亡率、标化死亡率、早死概率和年度变化百分率等指标。结果 2002-2017年,金山区居民慢性病死亡54 762例,占总死亡的90.17%,30~69岁居民慢性病死亡占慢性病死亡总数的26.31%,4类主要慢性病死亡占慢性病死亡总数的88.68%,男性和女性4类慢性病粗死亡率随时间呈上升趋势(APC=1.82%、1.21%,P<0.01),标化死亡率呈下降趋势(APC=-2.83%、-3.23%,P<0.01)。2002-2017年,4类慢性病早死概率从13.88%下降至8.53%,呈较明显下降趋势(APC=-3.34%,P<0.01),同期男性和女性慢性病早死概率也呈下降趋势(APC=-2.94%、-4.07%,P<0.01)。2002-2017年,心脑血管疾病、恶性肿瘤、慢性呼吸系统疾病和糖尿病早死概率为2.47%、7.24%、0.92%和0.43%,心脑血管疾病、恶性肿瘤和慢性呼吸系统疾病早死概率随时间呈下降趋势(APC=-3.86%、-2.53%、-11.28%,P<0.01),糖尿病早死概率随时间无明显变化趋势(APC=0.03%,P=0.98)。结论慢性病已成为金山区居民最主要的健康威胁。除糖尿病外,肿瘤、心脑血管疾病和慢性呼吸系统疾病所致早死概率呈持续下降趋势,应采取综合性防控措施来降低慢性病所致过早死亡。

Objective To understand the trend of probability of premature mortality caused by four major non-communicable diseases(NCDs) including cardiovascular diseases, cancers, chronic respiratory diseases and diabetes in Jinshan district of Shanghai from 2002 to 2017. Methods The death database of NCDs was established in Jinshan district from 2002 to 2017 and the crude death rate, standardized death rate, probability of premature mortality and annual percent change(APC) of four major NCDs were calculated. Results A total of 54 762 cases who died from NCDs were reported, accounting for 90.17% of all deaths in Jinshan district from 2002 to 2017.26.31% of deaths caused by NCDs were in the age group of 30-69 years, and 88.68% of deaths were caused by these four major NCDs.Crude death rate of four major NCDs increased both in males and in females(APC=1.82%, 1.21%, P<0.01), while the standardized death rate decreased(APC=-2.83%,-3.23%, P<0.01).During 16 years of study period, the probability of premature mortality caused by four major NCDs reduced from 13.88% to 8.53%(APC=-3.34%, P<0.01), which also showed a obvious down-ward trend in male and female residents(APC=-2.94%,-4.07%,P<0.01).From 2002 to 2017,the probabilities of premature mortality caused by cardiovascular diseases,cancers,chronic respiratory diseases and diabetes were 2.47%,7.24%,0.92%and 0.43%,respectively and the probabilities of premature mortality caused by cardiovascular diseases,cancers and chronic respiratory diseases decreased consistently(APC=-3.86%,-2.53%,-11.28%,P<0.01),while the probability of premature mortality caused by diabetes remained relatively stable(APC=0.03%,P=0.98). Conclusions NCDs are the major threat to the health of residents in Jinshan district.Although the probabilities of premature mortality caused by cardiovascular diseases,cancers,chronic respiratory diseases are decreasing gradually in recent years,the comprehensive measures should be taken to further prevent the premature mortality caused by the four major NCDs.